Previous Resident, Graduate Orthodontics and Dentofacial Orthopaedics Program, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Private Practice, London, Ontario, Canada.
Assistant Professor, Division of Oral and Maxillofacial Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
J Oral Maxillofac Surg. 2022 Jan;80(1):174-184. doi: 10.1016/j.joms.2021.08.163. Epub 2021 Aug 29.
Maxillomandibuar advancement (MMA) surgery has been shown to be a successful treatment for obstructive sleep apnea (OSA), but concerns still exist regarding esthetic outcomes due to the large advancements involved. The objective of this study was to evaluate facial profile changes in patients who underwent MMA surgery for OSA by utilizing panels of external evaluators.
Pre- and posttreatment silhouettes of 21 patients (10 females, 11 males; mean age 43.2 [±11.5] years), who underwent MMA surgery for OSA, were generated from profile photographs. Utilizing survey software, the individual silhouettes were shown in random order to surgeons, orthodontists and laypeople, who assessed the esthetics of each via a sliding visual analogue scale (0 to 10).
For all evaluators combined, postsurgical esthetic scores were significantly improved in 19 of 21 patients (P < .001). Ninety-five percent of evaluators judged the changes after surgery as positive or neutral. There was a mean increase in postsurgical esthetic scores of 1.9 [±1.9], which was moderately correlated with AHI changes (r = 0.48, P < .05). Mean esthetic score changes were significantly different between evaluator groups for 12 of 21 patients (P < .05), with surgeons and orthodontists reporting more positive change than laypeople.
Overall, MMA surgery for the treatment of OSA does not have a negative impact on facial profile esthetics, with external evaluators judging the changes as favorable in the majority of patients assessed.
上颌骨前移（MMA）手术已被证明是治疗阻塞性睡眠呼吸暂停（OSA）的有效方法，但由于涉及的大幅度推进，仍存在对美观结果的担忧。本研究的目的是通过外部评估小组评估接受 MMA 手术治疗 OSA 的患者的面部轮廓变化。
从侧位照片中生成 21 名患者（10 名女性，11 名男性；平均年龄 43.2[±11.5]岁）接受 MMA 手术治疗 OSA 前后的轮廓。利用调查软件，将个人轮廓随机显示给外科医生、正畸医生和非专业人士，他们通过滑动视觉模拟量表（0 到 10）评估每个轮廓的美观程度。
对于所有评估者的综合评分，21 名患者中有 19 名（P<0.001）的术后美观评分显著提高。95%的评估者认为手术后的变化是积极的或中性的。术后美观评分平均增加 1.9[±1.9]，与 AHI 变化中度相关（r=0.48，P<0.05）。在 21 名患者中有 12 名（P<0.05），评估者之间的平均美观评分变化存在显著差异，外科医生和正畸医生报告的变化比非专业人士更积极。
总体而言，MMA 手术治疗 OSA 不会对面部轮廓美观产生负面影响，大多数接受评估的患者的外部评估者认为这些变化是有利的。
